AB0599 CLINICAL AND SEROLOGICAL CHARACTERISTICS OF SERONEGATIVE PRIMARY SJÖGREN’S SYNDROME PATIENTS
Authors: A. Mihai, N. Adriana Elena, C. Jurcut, B. Cristian Florin, D. Anghel, D. Opris-Belinski, R. Ionescu
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Sjögren's syndrome (SS) is accompanied by a number of autoantibodies as a result of B cell aberrant activation. The clinical manifestations, laboratory findings and evolution in seronegativity of a pSS patient changes compared to a seropositive pSS patient. <h3>Objectives</h3> This study compared the clinical and serological characteristics of seronegative and seropositive primary Sjögren syndrome (pSS) patients and the differences in terms of treatment recommended during the follow-up period. <h3>Methods</h3> We performed a retrospective study in a single center, with 131 patients (128 women and 3 men) diagnosed with pSS. Clinical examinations, complete blood count, inflammatory and immunological parameters were determined at the initial visit. The patients were divided into two groups through the presence or absence of pathology-specific antibodies. <h3>Results</h3> Nineteen of the 131 pSS patients (14.5%) were triple seronegative for ANA, anti-Ro, and anti-La autoantibodies. pSS patients with the specific antibodies absence performed accessory salivary gland biopsy and based on focus score they were diagnosed seronegative. No significant statistical differences were observed for age, sex distribution, disease activity scores and the administrated treatment, between the two groups. In terms of laboratory findings, only total proteins, RF and IgG were statistically lower in seronegative pSS patients (p &lt; 0.05). While from glandular and extraglandular manifestations, singular xerostomia revealed a statistically significant between the two groups of pSS patients (p &lt; 0.001). Cellular ratio, NLR was positively correlated with ESSDAI score and MLR, and negatively correlated with PLR, ESR, total proteins, IgG, C3 and C4, in seronegative pSS patients (p &lt; 0.05). <h3>Conclusion</h3> The extraglandular manifestations and the administrated treatment, were similar for the two groups of pSS patients, while only the glandular manifestation, xerostomia, has a statistically significant difference. The hematological parameter, NLR, was statistically correlated with disease activity score and immunological markers in triple seronegative pSS patients. <h3>References</h3> [1]C. Vitali, S. Bombardieri, R. Jonsson, H.M. Moutsopoulos, E.L. Alexander, S.E. Carsons, T.E. Daniels, P.C. Fox, R.I. Fox, S.S. Kassan, S.R. Pillemer, N. Talal, M.H. Weisman, Classification criteria for Sjögren's syndrome: A revised version of the European criteria proposed by the American-European Consensus Group, Ann. Rheum. Dis. 61 (2002) 554–558. https://doi.org/10.1136/ard.61.6.554. [2]Yazisiz V, Aslan B, Erbasan F, Uçar İ, Öğüt TS, Terzioğlu ME. Clinical and serological characteristics of seronegative primary Sjögren's syndrome: a comparative study. Clin Rheumatol. 2021 Jan;40(1):221-229. doi: 10.1007/s10067-020-05154-9. Epub 2020 Jun 5. PMID: 32504193. [3]Chatzis LG, Pezoulas V, Voulgari PV, Baldini C, Exarchos TP, Fotiadis DI, Mavragani CP, Skopouli FN, Moutsopoulos HM, Tzioufas AG, Goules AV. Combined seronegativity in Sjögren's syndrome. Clin Exp Rheumatol. 2021 Nov-Dec;39 Suppl 133(6):80-84. doi: 10.55563/clinexprheumatol/47a4kr. Epub 2021 Oct 4. PMID: 34665703. [4]Segal BM, Pogatchnik B, Henn L, Rudser K, Sivils KM. Pain severity and neuropathic pain symptoms in primary Sjögren's syndrome: a comparison study of seropositive and seronegative Sjögren's syndrome patients. Arthritis Care Res (Hoboken). 2013 Aug;65(8):1291-8. doi: 10.1002/acr.21956. PMID: 23335582; PMCID: PMC4137866. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.